BILL NUMBER: AJR 32	CHAPTERED  09/14/99

	RESOLUTION CHAPTER   113
	FILED WITH SECRETARY OF STATE   SEPTEMBER 14, 1999
	ADOPTED IN SENATE   SEPTEMBER 9, 1999
	ADOPTED IN ASSEMBLY   SEPTEMBER 1, 1999
	AMENDED IN ASSEMBLY   AUGUST 30, 1999

INTRODUCED BY   Assembly Members Strickland and Gallegos

                        AUGUST 16, 1999

   Assembly Joint Resolution No. 32--Relative to Medicare
reimbursement for nursing home services.


	LEGISLATIVE COUNSEL'S DIGEST


   AJR 32, Strickland.  Medicare payments.
   This measure would memorialize the Congress of the United States
to enact legislation to require the Medicare prospective payment
system to take into account the costs associated with providing
medically complex care and to provide a more accurate inflation
adjuster index.




   WHEREAS, The United States Congress enacted short-term Medicare
reforms as part of the Budget Act of 1997; and
   WHEREAS, These reforms included changes in the manner in which the
federal government reimburses nursing homes around the country for
Medicare patient claims.  In an effort to save $115 billion over a
10-year period, the new law changes the reimbursement method from
fee-for-service to flat rate reimbursement; and
   WHEREAS, Since the enactment of these reforms, Medicare spending
during the first half of the 1998-99 fiscal year was $2.6 billion
less than for the comparable six-month period of the 1997-98 fiscal
year; and
   WHEREAS, Under the new, lower reimbursement rates, most nursing
homes lose money on patients who require intravenous antibiotics,
tube feeding, dialysis, or ventilator support; and
   WHEREAS, Changes in the method of reimbursing nursing homes for
the care of Medicare beneficiaries results in many nursing homes
refusing Medicare patients, or places these homes in serious
financial jeopardy; now, therefore, be it
   Resolved by the Assembly and Senate of the State of California,
jointly, That the Legislature respectfully memorializes the United
States Congress to enact legislation to require the Medicare
prospective payment system to take into account the costs associated
with providing medically complex care, such as ventilator care,
tracheostomy care, and care for pressure ulcers, and to provide a
more accurate inflation adjuster index.
